18 Del. Admin. Code § 101-2.0

Current through Register Vol. 28, No. 5, November 1, 2024

Section 101-2.0 - Claims and Investigation

2.1 Through investigation, the Insurance Department attempts to assure fair and honest dealings between insurers, agents and policyholders in all insurance matters.

2.1.1 Receives all complaints by and against agents and policyholders.

2.1.2 An investigator obtains, through investigation, all available data necessary to properly evaluate a claim.

2.1.3 A review is made of the estimate of losses in all claims involving fire and casualty to determine if an offer is based on a legitimate estimate.

2.1.4 Frequently an informal conference is held between policyholders and company adjusters hoping that the conference will bring forth a meeting of minds.

2.1.5 The Department is constantly alert for violations of the Unfair Trade Practices Act (18 Del.C. Ch.23) and investigates any apparent violations of such Act. Results are submitted to the Commissioner for his determination.

2.1.6 The Department reviews advertising materials to determine if unauthorized insurers are soliciting business within this State, and if so, seeks voluntary discontinuance of such advertising and solicitation. The facts are presented to the Commissioner for his order, ordering the offending party to show cause why an order should not be issued ordering such party to cease and desist.

2.1.7 The Department promptly investigates all complaints of every kind and nature and takes such action within the law as the facts and the relationship of the parties dictate; investigation is made regardless of the amount involved and the policyholder is informed as to the Department's view and if the claim is deemed uncollectible, the file is closed.

2.1.8 The Department actively participates in third party claims only when it appears that the company or its representatives is acting in bad faith.

18 Del. Admin. Code § 101-2.0